Journal article
Weight-bearing radiographs and cone-beam computed tomography examinations in adult acquired flatfoot deformity
Foot and ankle surgery, Vol.27(2), pp.201-206
02/2021
DOI: 10.1016/j.fas.2020.04.011
PMID: 32475795
Abstract
•Moderate to very good correlation was noted between weightbearing radiographic and weightbearing CT measurements.•Angular measurements were overall increased in weightbearing CT images, comparing with weightbearing radiographs.•Compared to 3D weightbearing CT, weightbearing radiographs can potentially underestimate adult acquired flatfoot severity.•In patients with adult acquired flatfoot, limitations of weightbearing radiographic evaluation should be considered.
Optimal characterization of Adult acquired flatfoot deformity (AAFD) on two-dimensional radiograph can be challenging. Weightbearing Cone Beam CT (CBCT) may improve characterization of the three-dimensional (3D) structural details of such dynamic deformity. We compared and validated AAFD measurements between weightbearing radiograph and weightbearing CBCT images.
20 patients (20 feet, right/left: 15/5, male/female: 12/8, mean age: 52.2) with clinical diagnosis of flexible AAFD were prospectively recruited and underwent weightbearing dorsoplantar (DP) and lateral radiograph as well as weightbearing CBCT. Two foot and ankle surgeons performed AAFD measurements at parasagittal and axial planes (lateral and DP radiographs, respectively). Intra- and Inter-observer reliabilities were calculated by Intraclass correlation (ICC) and Cohen’s kappa. Mean values of weightbearing radiograph and weightbearing CBCT measurements were also compared.
Except for medial-cuneiform-first-metatarsal-angle, adequate intra-observer reliability (range:0.61−0.96) was observed for weightbearing radiographic measurements. Moderate to very good interobserver reliability between weightbearing radiograph and weightbearing CBCT measurements were observed for the following measurements: Naviculocuneiform-angle (ICC:0.47), Medial-cuneiform-first-metatarsal-gapping (ICC:0.58), cuboid-to-floor-distance (ICC:0.68), calcaneal-inclination-angle(ICC:0.7), axial Talonavicular-coverage-angle(ICC:0.56), axial Talus-first-metatarsal-angle(ICC:0.62). Comparing weightbearing radiograph and weightbearing CBCT images, statistically significant differences in the mean values of parasagittal talus-first-metatarsal-angle, medial-cuneiform-first-metatarsal-angle, medial-cuneiform-to-floor-distance and navicular-to-floor-distance was observed (P < 0.05).
Moderate to very good correlation was observed between certain weightbearing radiograph and weightbearing CBCT measurements, however, significant difference was observed between a number of AAFD measurements, which suggest that 2D radiographic evaluation could potentially underestimate the severity of AAFD, when compared to 3D weightbearing CT assessment.
Details
- Title: Subtitle
- Weight-bearing radiographs and cone-beam computed tomography examinations in adult acquired flatfoot deformity
- Creators
- Delaram Shakoor - Johns Hopkins UniversityCesar de Cesar Netto - University of IowaGaurav K Thawait - Johns Hopkins UniversityScott J Ellis - Hospital for Special SurgeryMartinus Richter - Department for Foot and Ankle Surgery Rummelsberg and Nuremberg, Germany.Lew C Schon - MedStar Union Memorial HospitalShadpour Demehri - Johns Hopkins UniversityInternational Weight Bearing CT Society
- Resource Type
- Journal article
- Publication Details
- Foot and ankle surgery, Vol.27(2), pp.201-206
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.fas.2020.04.011
- PMID
- 32475795
- ISSN
- 1268-7731
- eISSN
- 1460-9584
- Language
- English
- Date published
- 02/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303971702771
Metrics
14 Record Views